A Major Blow Against Healthcare Fraud: Two Women Accused in Extensive Medicaid Scheme

In a troubling development that underscores the relentless fight against healthcare fraud, two women, one from Hartford, Connecticut, and another from Ludlow, Massachusetts, are now facing serious charges in connection with an alleged Medicaid fraud scheme. Authorities claim this operation siphoned over $600,000 from the vital public assistance program through fraudulent billing for services that were either never provided or significantly incomplete.

The individuals at the center of these allegations are Alyse Enderle, a 34-year-old board-certified behavior analyst and the proprietor of Autism Sparkles, an East Windsor-based organization, and Carmen Wynter, a 38-year-old behavioral technician from Hartford who worked for the same company. Investigators allege that the fraudulent activities spanned a significant period, from December 2021 right up to September 2023. Enderle, who reportedly lived in Connecticut previously, was arrested on September 21st, while Wynter's arrest followed a few days later on September 24th.

So, how did this alleged scheme unfold? Essentially, officials claim that both Enderle and Wynter conspired to submit a slew of false claims to Medicaid. These claims, totaling a staggering $353,805.99, were supposedly for behavioral health services that just weren't delivered or weren't fully delivered as billed. But that's not all; separate from the alleged conspiracy, Enderle herself is accused of submitting an additional $248,164.91 in improper claims for unprovided or incomplete services. When you add it all up, we're talking about an alleged loss exceeding $600,000 for the state's Medicaid program.

The charges levied against these women are quite severe, reflecting the gravity of defrauding a public community. Both Wynter and Enderle face counts of first-degree larceny by defrauding a public community, health insurance fraud, and conspiracy charges for both offenses. These are classified as Class B felonies in Connecticut, which means a conviction could potentially lead to a prison sentence of up to 20 years. Each woman was released after posting a $150,000 non-surety bond, but their legal journey is just beginning. Enderle is scheduled to appear in New Britain Superior Court on September 29th, while Wynter's court date is set for October 1st.

Bringing a case like this to light requires a truly collaborative effort, and a number of key agencies worked tirelessly on this investigation. Leading the charge was the Office of the Chief State's Attorney, specifically the State's Medicaid Fraud Control Unit. They received crucial assistance from the State Department of Social Services' Office of Quality Assurance, the U.S. Department of Health and Human Services Office of Inspector General, the Connecticut Attorney General's Office, and even the New Britain police. It's a testament to these dedicated teams that such extensive alleged fraud is being brought to justice, protecting essential resources for those who truly need them.